Talk, Action and Belief

About the Book

Talk, action and belief: How the intentionality model combines attachment-oriented psychodynamic therapy and cognitive behavioural therapy Contents List of illustrations and tables Preface I Overview 1 - The problems of practising The lack of consensus across schools Not justifying practice by empirical research alone Ethical and effective practice Against the provision of a narrow set of interventions 2 - The intentionality of consciousness Overview Eight prerequisites of intentionality for change Some conclusions about single forms of intentionality Composite or complex combinations of intentionality 3 - The intentionality model Mapping experiential differences The commonality of intentionality in talk and action Ten keys to the intentionality model Towards criteria for good practice II Psychodynamics of providing ad receiving care through talk and action 4 - Using attachment theory for understanding relationships The need for an experientially-based theory Defining empathy Husserl’s account of empathy The consequences of empathy Intersubjectivity is the social condition for knowledge and understanding Introducing attachment The strange situation Dynamic thinking about attachment The map of attachment 5 - The inter-relation between self and other Professional and personal aspects of attachment One-way and two-way caring The continuum: Avoidance, ambivalence and security Avoidance Ambivalence Security Overview of general insecure attachment dynamics The insecure view of self The insecure view of the other The future of the relationship Conclusion on security 6 - The basics of talking and relating Defining communication The psychological reality of attachment Contemporary research on attachment processes: The dance of attachment The positive contribution of Freud Resistance Mis-empathy Working with resistance and mis-empathy 7 - Working to increase security Overview The dynamics of attachment as the greatest contributory factor Towards a sufficiently secure therapeutic relationship Criteria for promoting secure attachment Introducing the social skills for talking and relating Discussion of bad practice: Criteria for decreasing security Criteria for bad practice On the emotional reactions of therapists Working with client emotions Five recommendations about good practice 8 - Action, choice and motivation Behaviour therapy On choice Practical intentionality as part of the whole The extent of the ego Choosing and wanting Personality and social choices Motivation supports choice Promoting behavioural change as the most ethical therapy Healing through exposure to anxiety III Psychopathology, belief and the treatment of belief 9 - The psychological worldview of the intentionality model Introduction Intentionality as the link between personality, problem, practice and self-management More details on the intentionalities Putting the pieces together: Intentionality, sense, object, context Meaning is a social phenomenon On cultural objects The living sense of self as the basis of personality The basics for a qualitative psychology of self in context Varying senses of self In closing: The use of these ideas 10 - The biopsychosocial view of personalities and problems Introduction Biological Social Psychological Addressing personalities and problems as a whole Personality as social Understanding the defensive function of the personality Discussion Conclusion for the biopsychosocial view 11 - Hermeneutics and belief The argument of this chapter Different interpretations of self at different points in the lifespan Overview of psychological hermeneutics Therapy examples Understanding everyday experience Belief as the result of interpretation The philosophical understanding of belief Husserl on belief Psychological beliefs Implicit and explicit belief Closing discussion 12 - Examples of interpreting belief The work of belief Growing up is learning how to believe Unchanging belief as representative of problems Examples of belief driving self-harm and self-neglect Sheila: An under-performing manager 13 - Meta-representation and the developmental origin of belief Introduction Defining meta-representation Meta-representation and relationships Working with meaning and belief Accuracy and inaccuracy of belief in development Discussion Empirical research in the theory of mind IV The practice of talk, action and belief 14 - Assessment The purpose of assessment On assessment Estimating the suitability of therapy Understanding risk Personality and problems as a whole Contra-indications for assessment and therapy Screening Turning down prospective clients Recommending help 15 - Treatment planning Introduction to practice Talk only Talk and action in the same session Talk then action across treatment Action then talk across treatment Action only 16 - How to formulate and work with belief Introduction to interpreting psychopathology and primary mental health problems Understanding personality and problems as a whole On functioning: from defence to coping Recap: The differences between natural cause and psychological ‘cause’ Natural cause Psychological ‘cause’ Formulation is interpretation Original on-set Developmental formulation On maintenance formulation Formulating the primary mental health problem How to formulate Written example: Binge eating Verbal example: Challenging inaccurate beliefs Discussion of working with belief 17 - Intentionality and evidence Evidence and its interpretation Interpreting the past Interpreting the perceptual present Interpreting the future Discussion 18 - Six meaningful worldviews Background Shame and low self-esteem in relation to others Suicide and self-harm Eating disorders Neglect in the family of origin Attempts at security in talking therapy Spoken or unspoken dissatisfaction 19 - Interventions concerning talk and relating Returning to empathy On non-verbal communication The consequences of an attention to non-verbal communication On emotion Primary and secondary emotion Structuring sessions Structuring a first session Agenda setting Improving empathic understanding Problems in talking and relating Speech acts Reviews How to foreclose Planned endings 20 - Interventions concerning action and meaning Criteria concerning choice, motivation and planning Working on the primary problem of functioning and mood Self-esteem How to do functional analysis Three steps for problem-solving One day at a time Workshop approach Decreasing impulsivity and increasing self-control Distractions Time management Irrational thoughts Parallels paths Death anxiety Survey of understanding about social situations 21 - Some cases showing the role of intentionality Opening remarks Talk only Action: Working with obsessive compulsive disorder Action: Binge eating Talk and action: A case of excessive alcohol intake Using supervision 22 - Conclusion Intentionality is the key Belief Looking to the future Bibliography

About the Author

Ian Rory Owen has been in practice since 1987 in a variety of different roles and has taught on a British Psychological Society approved Doctorate in Counselling Psychology. He has 69 papers published in a variety of internationally renowned peer-reviewed journals. He is the author of two previous books on integrative therapy from a phenomenological perspective. This most recent work is a manual of how to practice an experiential approach to cognitive behavioural therapy by attending to the conscious meaningful experiences. Research findings on the therapeutic relationship as a dynamic attachment relationship are presented in order to aid the management of therapy meetings. See www.intentionalitymodel.info for details. Ian Rory Owen works in Leeds, UK, within a an adult psychology department within the British National Health Service.